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Good practice guide

Emergency departments

Self-assessment checklist for NHS boards

  • We have worked with the Scottish Government to develop robust benchmarking data to ensure available resources are being used effectively and ensure consistency in terminology and standards across services.
  • We accurately apply ISD Scotland emergency department data definitions, including the definition for self-referral, and ensure that
    staff are trained and apply the definitions appropriately.
  • We have worked with the Scottish Government to review the benefits of the use of short-stay wards / observation units and worked together to develop guidance on best working practice to inform how services should be configured.
  • We have explored the scope for GPs to refer emergency patients direct to the relevant admission unit in the hospital without first attending the emergency department.
  • We have worked with ISD Scotland to explore variation in attendance rates and rates of admission.
  • We have reviewed the effectiveness of holding planned clinics within the emergency department.
  • We have worked with ISD Scotland to develop measures of case-mix to help with benchmarking services.
  • We have worked with the rest of the hospital and other services to further reduce delays at emergency departments, for example reviewing bed management arrangements and reducing length of stay.
  • We have ensured that appropriate facilities for children are in place within emergency departments.
  • We have improved services for people attending emergency departments with a mental health problem.
  • We have ensured that services at emergency departments meet the needs of patients with a disability.
  • We have worked with the Scottish Government to ensure that clear guidelines are available to partner services and the public on the services provided at minor injuries units.
  • We have identified the scope for referring patients to minor injuries units, using clinically appropriate guidelines.
  • We have worked with other boards to ensure there is consistency in our approach to out-of-hospital care initiatives.
  • We ensure that systems are in place for tracking patients who frequently attend emergency departments and explore the opportunities to improve the experience for these patients.
  • We have carried out work to understand local variation in referrals to emergency departments and review and feed back any concerns about referrals to partner services to help manage demand.
  • We ensure that initiatives for reducing attendances at emergency departments are underpinned by evidence of their effectiveness and the impact on patient care, costs and the wider health and social care system.

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